Background: Acute psychiatric wards manage patients whose actions may threaten safety\n(conflict). Staff act to avert or minimise harm (containment). The Safewards model\nenabled the identification of ten interventions to reduce the frequency of both.\nObjective: To test the efficacy of these interventions.\nDesign: A pragmatic cluster randomised controlled trial with psychiatric hospitals and\nwards as the units of randomisation. The main outcomes were rates of conflict and\ncontainment.\nParticipants: Staff and patients in 31 randomly chosen wards at 15 randomly chosen\nhospitals.\nResults: For shifts with conflict or containment incidents, the experimental condition\nreduced the rate of conflict events by 15% (95% CI 5.6ââ?¬â??23.7%) relative to the control\nintervention. The rate of containment events for the experimental intervention was\nreduced by 26.4% (95% CI 9.9ââ?¬â??34.3%).\nConclusions: Simple interventions aiming to improve staff relationships with patients can\nreduce the frequency of conflict and containment.
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